Pharm Exam

A nurse is performing discharge teaching for a client who is taking phenytoin (Dilantin). Which of the following comments by the client should alert the nurse that further teaching is needed?

"I'll be glad when I am free of seizures so I can stop taking this medicine." Phenytoin is an anticonvulsant used to treat various types of seizures. Clients on anticonvulsant medications commonly require them for lifetime administration, and phenytoin should not be stopped without the advice of the client's provider.

​A nurse is preparing to administer haloperidol (Haldol) 5 mg IM to a client. Available is haloperidol 20 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest hundredth.)

.25 ml

​A client who has a gastric ulcer is about to start taking sucralfate (Carafate). The nurse determines that teaching was effective when the client states that he will take this medication

1 hr before meals and at bedtime. ​ Sucralfate creates a protective coating over the ulcer. To achieve this, the client should take it on an empty stomach - 1 hr before each meal and at bedtime.

A client with severe pancreatitis is receiving total parenteral nutrition (TPN). The physician prescribes 1,800 mL to be infused at a continuous rate over 24 hr. At how many mL/hr should the nurse set the IV pump?

1,800 mL ÷ 24 hr = 75 mL/hrIV pumps can only be set to deliver hourly rates.

A home health nurse is reviewing the medication list of an older adult client who reports falling a couple of times over the past week. Which of the following medications should the nurse suspect is contributing to the client's falls?

Alprazolam (Xanax) Alprazolam is a CNS depressant that can cause dizziness and lightheadedness which may be a contributing factor to the client's loss of balance and falling.

A nurse is preparing to administer an IV injection of phenytoin (Dilantin) to a client. Which of the following nursing actions is appropriate?

Administer a saline solution after injection. ​The nurse should immediately flush the injection site with a saline solution after the injection of phenytoin (Dilantin). This intervention helps reduce and prevent venous irritation.

​A nurse is caring for a client who develops Wernicke's encephalopathy as a result of chronic alcohol abuse. Which of the following interventions should the nurse anticipate?

Administration of thiamine (Vitamin B1) ​Administration of thiamine is a priority intervention for the client who has Wernicke's encephalopathy.

A client is receiving pancreatic enzymes as a digestive aid. The nurse should tell the client expect which of the following gastrointestinal changes?

Decreased fat in stools Clients who have cystic fibrosis or pancreatitis, for example, need to supplement meals with oral pancreatic enzymes to reduce the fat content in their stools. Clients receiving pancreatic enzymes as a digestive aid should expect to have a reduction of fat in their stools.

A nurse is caring for a client who has a prescription for clozapine (Clozaril). Which of the following is an expected response to this medication?

​Decreased auditory hallucinations. ​Clozapine is prescribed for the treatment of psychotic findings which include auditory hallucinations. Adverse response= seizures, hypotension, fatigue

​When talking with a patient about taking cimetidine (Tagamet), the nurse should include which of the following instructions?

​Do not take this medication if you start taking blood-thinning medications. ​Cimetidine can interfere with the absorption of warfarin (Coumadin) and several other medications, including phenytoin (Dilantin) and propranolol (Inderal).

​A nurse is caring for a client in liver failure with ascites who is receiving spironolactone (Aldactone). Which of the following outcomes should the nurse expect from this client's medication therapy?

​Increased sodium excretion ​The primary action of spironolactone is to increase sodium excretion in the urines.

​A nurse is caring for a client who has just begun therapy with alprazolam (Xanax) to treat anxiety. The nurse should observe the client for which of the following adverse effects of this medication?

​Sedation ​Sedation and drowsiness are common side effects of this medication.

​A nurse is administering medication to a client. Which of the following medications is most effective when administered with little or no water?

​Sucralfate (Carafate) ​Sucralfate (Carafate) is given as a protective barrier in the stomach to protect against excessive acid erosion. Sucralfate coats the stomach and is not absorbed systemically, making administration of additional fluid unnecessary. The purpose of a full glass of water for most oral medications is to promote absorption of medications systemically, thus this medication does not benefit from water or any other fluid. This medication does not need to be diluted.

A nurse is caring for a client who reports occasionally self-medicating with an over-the-counter calcium carbonate antacid. To avoid the adverse effects of calcium carbonate, the nurse should recommend that the client take this medication with

water. Calcium carbonate is a dietary supplement used when the amount of calcium taken in the diet is not enough. Calcium carbonate may also be used as an antacid to relieve heartburn, acid indigestion, and stomach upset. The client should drink a full glass of water after taking an antacid to enhance effectiveness.

​A nurse is caring for a client who reports taking bisacodyl (Ducolax) to promote a daily bowel movement. Which of the following should be the nurse's priority response?

​"How long have you been taking the Ducolax"​ Bisocodyl is a stimulant laxative indicated for short-term use due to a risk of dependency. It is important for the nurse to determine the history, specifically the length of time the client has relied on this medication for bowel elimination.

A nurse is teaching a client who takes pain medication and was recently prescribed docusate sodium (Colace). Which of the following statements indicates the client understands the information?

​"I am to have 1 to 2 soft stools each day." ​The client's understands docusate sodium is a stool softener and the therapeutic effect is achieved when having 1 to 2 soft stools each day.

​A nurse is talking with a client who has peptic ulcer disease and is starting therapy with sucralfate (Carafate). The nurse should instruct the client to take the medication

​1 hr before meals. ​Sucralfate is a mucosal protectant. The client should take it on an empty stomach, 1 hr before meals, for maximum effectiveness.

A nurse is teaching a client who has multiple sclerosis about starting therapy with baclofen (Lioresal). Which of the following instructions should the nurse include?

​Avoid driving until the drug's effects are evident. ​Several CNS-related effects are common, including drowsiness, dizziness, headache, and confusion. Therefore, until the client knows show the medication will affect him, he should not drive a vehicle.

​A nurse is reviewing the history and physical for a client who has schizophrenia. Reported findings include jerky choreiform movements, lip smacking, and neck and back tonic contractions. These findings are chronic despite the discontinuation of chlorpromazine (Thorazine). The nurse should suspect that the client has developed which of the following adverse effects?

​Tardive dyskinesia ​These findings indicate tardive dyskinesia which is persistent even with the discontinuation of the conventional antipsychotic.

A nurse is speaking with a client who is about to receive a one-time dose of diazepam (Valium). Which of the following information should the nurse be sure to give to the client?

Diazepam can cause drowsiness. ​Valium has sedative properties, so the client should not engage in potentially hazardous activities after receiving diazepam.

​A nurse is caring for a client who has been prescribed timolol (Timoptic). Which of the following is the appropriate procedure for administration of this medication?

Drop prescribed amount of medication into the conjunctival sac. ​With the dominant hand resting on client's forehead, hold filled medication eyedropper or ophthalmic solution approximately 1-2 cm above conjunctival sac. Instill prescribed number of medication drops into the conjunctival sac. After instilling drops, ask client to close eye gently. If the client is to receive more than one eye medication to the same eye, wait at least 5 min before administering the next medication.

A provider prescribes fluoxetine (Prozac) for a client who reports frequent periods of extreme sadness. The nurse teaching the client knows he understands how to take this medication when he makes which of the following statements?

I'll take this medicine first thing in the morning ​The usual recommendation is to take fluoxetine as a single dose in the morning.

​A nurse is preparing to administer a bisacodyl (Dulcolax) 10 mg suppository. Which of the following are correct administration guidelines for the nurse to implement?

Lubricate index finger. Insert suppository just beyond internal sphincter is correct The rounded end of the suppository should be lubricated with a sterile water-soluble lubricating jelly. In addition to lubricating the suppository, the index finger of the nurse's dominant hand should be lubricated with a water-soluble lubricant to promote insertion. The nurse should gently retract the buttocks with the nondominant hand. The suppository should be inserted gently through the anus, past the internal sphincter, and against the rectal wall. Following the administration of the medication, the nurse should apply gentle pressure to hold the buttocks together momentarily if needed to keep medication in place. The internal sphincter is constantly contracted and prevents small amounts of stool from leaking from the rectum and will hold the suppository in place.

​A client tells the nurse she took a dose of dimenhydrinate (Dramamine) before coming to the health care clinic. The nurse determines that the medication is effective when the client reports relief of

Nausea ​Dimenhydrinate helps prevent and treat motion sickness. It also treats vertigo and reduces nausea and vomiting from radiation sickness.

​A nurse has just administered a dose of diazepam (Valium) to a client. Which of the following actions should the nurse take before she leaves the client's room?

Put up the side rails on the client's bed. ​Diazepam is a benzodiazepine that causes sedation and has antianxiety and muscle relaxation properties. For the client's safety, the nurse should raise the side rails, place the bed in the lowest position, and make sure the client's call light access device is within reach.

A nurse who is teaching a client who is about to start taking docusate (Colace) should make sure that the client understands that this medication should result in

Regular Bowel movements The intended outcome of docusate therapy is to produce stool that is softer in consistency and easier for the client to pass. That should improve the regularity of the client's bowel movements.

A nurse is caring for a 2-year-old child who is receiving phenytoin (Dilantin) in suspension form. Which of the following actions should the nurse take before administering each dose?

Shake the container vigorously. A suspension form of medication refers to one in which the particles of medication are mixed with, but not dissolved in, a fluid. It is important for the nurse to shake the container that contains the suspension, because the child can be under-medicated if the medication is not evenly distributed.

​A nurse is to administer a rectal suppository to a client. The nurse should instruct the client to lie in which of the following position's while in bed?

Sim's position ​The Sim's position exposes the anus and helps the client relax the external sphincter while lying in bed. This allows for easier insertion of the suppository.

​A client has started to take lithium carbonate (Eskalith) to treat bipolar disorder. The nurse should make sure the client understands that he must maintain consistency in his intake of which of the following dietary elements?

Sodium ​Lithium is a salt. If sodium level falls, the client will retain lithium and have an increased risk for lithium toxicity.

​A client is receiving lithium carbonate (Eskalith) to treat manic behavior. The nurse caring for this client should use which of the following strategies to guide the administration of this medication?

​Telling the client to expect control of manic symptoms 7 to 10 days after starting lithium therapy ​It will take 7 to 10 days before the client experiences a decrease in the manic symptoms

A nurse is attempting to administer a dose of lactulose (Cephulac) to a client who has cirrhosis when the client states, "I don't need this medication. I am not constipated." The nurse should explain that lactulose is also used to decrease serum

ammonia. Lactulose, a disaccharide, is a sugar that works as an osmotic diuretic. It prevents absorption of ammonia in the colon. Accumulation of ammonia in the bloodstream, which occurs in pathologic conditions of the liver, such as cirrhosis, may affect the central nervous system, causing hepatic encephalopathy or coma.

A client admitted to an inpatient mental health unit is about to start receiving disulfiram (Antabuse). Which of the following information is most important for the nurse to obtain before administering this medication?

​When the client last drank alcohol ​Disulfiram is a type of aversion therapy that helps maintain abstinence from alcohol. Therapy must not begin until the client has abstained from alcohol for at least 12 hr and preferably for 48 hr.

A client has been taking omeprazole (Prilosec) for the past 4 weeks. The nurse determines that the medication is effective when the client reports relief from

​acid indigestion. ​Omeprazole, a proton pump inhibitor, reduces gastric acid secretion and treats duodenal and gastric ulcers, prolonged dyspepsia, gastrointestinal reflux disease, and erosive esophagitis.

A nurse is caring for a client who is in renal failure with an elevated serum phosphorous level and is to be started on aluminum hydroxide (Amphojel). The client asks the nurse about potential side effects. The nurse should explain to the client that a common side effect of aluminum-based antacids is

constipation. Aluminum-based antacids have few side effects, and the most common one is constipation. They have chalky taste

A client is about to start taking aluminum hydroxide (Amphojel) to treat heartburn. The nurse should explain to the client that this medication can cause

constipation. This type of antacid can cause constipation, so the nurse should tell the client to increase fluid and fiber intake and to exercise more to help prevent this effect.

A nurse is instructing a pediatric client and his and family about how methylphenidate (Ritalin) will help manage attention-deficit hyperactivity disorder (ADHD). The nurse should explain that this medication therapy will help

increase focus. ​Methylphenidate acts on the cerebral cortex to create a stimulating effect that helps increase focus on metal activities and tasks.

A nurse at an ophthalmology clinic is caring for a client who has open-angle glaucoma. The client is started on a treatment regimen of timolol (Timoptic) and pilocarpine (Pilocar) eye drops. The nurse should understand that these medications will be administered

on a regular schedule for the rest of the client's life. Medications prescribed for glaucoma are intended to enhance aqueous outflow, or decrease its production, or both. The client must continue the eye drops on an uninterrupted basis for life.

A nurse is interviewing a client during a yearly health assessment. The client reports occasionally taking several over-the-counter (OTC) medications, including H2-blockers, as needed. When evaluating the effectiveness of H2-blocker therapy, the nurse should assess for

relief of heart burn Histamine H2-receptor antagonists, also known as H2-blockers, are used to treat duodenal ulcers and prevent their return. In OTC strengths, these medicines are used to relieve or prevent heartburn, acid indigestion, and sour stomach.

A nurse is caring for client who has a prescription for phenytoin (Dilantin). For which of the following findings should the nurse instruct the client to notify the provider?

skin rash ​Phenytoin is an antiepileptic medication used to treat partial seizures and generalized tonic-clonic seizures. It slows the entrance of sodium and calcium back into the neuron and extends the time it takes for the nerve to return to its active state. Phenytoin can cause a rash that may progress to more serious conditions, such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). If a rash develops, the client should notify the provider immediately and stop the use of phenytoin.